Elaine Farmer - Academia.edu (original) (raw)

Papers by Elaine Farmer

Research paper thumbnail of Improving Reunification Practice: Pathways Home, Progress and Outcomes for Children Returning from Care to Their Parents

British Journal of Social Work, 2012

Research paper thumbnail of Achieving Positive Outcomes when Reunifying Children – The Reunification Practice Framework

Research paper thumbnail of Fostering adolescents in England: what contributes to success?

Research paper thumbnail of Changing lives and changing minds: the experiences of adoptive parents from application to approval

Adoption & Fostering, 2014

The recruitment and preparation of adoptive parents is currently high on the government's agenda ... more The recruitment and preparation of adoptive parents is currently high on the government's agenda with a number of far-reaching changes in policy, processes and guidance having been introduced in recent months. The fundamental aim of adoption from care remains as being the provision of, hopefully, stable and loving families for children whose parents cannot care for them but the experiences of adoptive parents in this process has recently moved from the wings to centre stage. This paper introduces the reflections of a group of adoptive parents (n=27) about their experience of becoming adopters. The impact of delays in the process and experiences of the preparation and assessment period are discussed. A particular focus of the paper is on adopters' thoughts about the sorts of children they felt they could parent and how these changed in the course of their approval journey.

Research paper thumbnail of What Factors Relate to Good Placement Outcomes in Kinship Care?

British Journal of Social Work, 2009

Since recent legislation and other developments are likely to lead to increased use of placements... more Since recent legislation and other developments are likely to lead to increased use of placements with kin, this paper considers the evidence base about the factors that relate to good outcomes in kinship care in England. It is based on a study using case file reviews on 270 children, half of whom were in kin and half in stranger foster

Research paper thumbnail of Support for Adoption Placements: The First Six Months

British Journal of Social Work, 2013

The version in the Kent Academic Repository may differ from the final published version. Users ar... more The version in the Kent Academic Repository may differ from the final published version. Users are advised to check http://kar.kent.ac.uk for the status of the paper. Users should always cite the published version of record.

Research paper thumbnail of Foster Carer Strain and its Impact on Parenting and Placement Outcomes for Adolescents

British Journal of Social Work, 2005

Summary Drawing on recently completed research funded by the Department of Health, this article e... more Summary Drawing on recently completed research funded by the Department of Health, this article examines the extent of strain on the foster carers of adolescents, its influence on parenting practices and the overall impact on placement outcomes. The research find ings show that foster-carers' parenting capacity was markedly reduced in a number of specific areas when they had experienced a high number of stressful life events in the six months prior to the young person's arrival or were under considerable strain during the placement. Conduct problems, hyperactivity and violent behaviour by the young people increased carer strain, as did contact difficulties with the children's families. Problems in contacting social workers were linked to elevated strain, whilst strain was lessened when carers received help from friends or from local professionals. Signifi cantly higher disruption rates were experienced by strained carers and these placements were also less beneficial to the young people.

Research paper thumbnail of The Reunification of Looked After Children with Their Parents: What Contributes to Return Stability?

British Journal of Social Work, 2012

ABSTRACT Research information about reunification in the UK is scarce. Based on a prospective stu... more ABSTRACT Research information about reunification in the UK is scarce. Based on a prospective study of 180 children returned to their parent(s) in six local authorities in England, this article examines the factors that contributed to return stability during a two-year follow-up. Statistical analyses using logistic regression showed that a change in family membership since the child had entered care, foster carer assistance with returns, adequate preparation for and support during reunification, parental motivation to care and the involvement of another agency or professional in monitoring children were all related to return stability. Previous physical abuse to the child and previous failed returns were associated with reunification breakdown. The breakdown rates for the returns in our local authorities varied widely, especially for older children. Given the contribution of purposeful social work to return stability - as evidenced by appropriate preparation, services and monitoring of children's progress - local authorities need to develop clearer policies and practice advice on reunification for all children, whatever their legal status or age, backed up by appropriate resources. © The Author 2012. Published by Oxford University Press on behalf of The British Association of Social Workers. All rights reserved.

Research paper thumbnail of Implementing a Therapeutic Team Parenting Approach to Fostering: The Experiences of One Independent Foster-Care Agency

British Journal of Social Work, 2010

... Farmer E.,; Moyers S.,; Lipscombe J. Fostering Adolescents. London: Jessica Kingsley; 2004. .... more ... Farmer E.,; Moyers S.,; Lipscombe J. Fostering Adolescents. London: Jessica Kingsley; 2004. ... Adoption and Fostering 2006;30(3):6-16. ↵: Osborne C.,; Norgate R.,; Traill M. 'The role of the educational psychologist in multidisciplinary work relating to fostering and adoption'. ...

Research paper thumbnail of Patterns of Placement, Management and Outcome for Sexually Abused and/or Abusing Children in Substitute Care

British Journal of Social Work, 2004

This paper draws on the author's research on the management, care and treatment of sexually a... more This paper draws on the author's research on the management, care and treatment of sexually abused and/or abusing children in substitute care. The research, funded by the Department of Health, examined the management and treatment provided in residential and foster care for these young people, the mix of children in each setting and the steps taken to keep these and other children safe. Analysis of the findings revealed four distinct groups of young people in this population, each of which required somewhat different management approaches and placement type, whilst very varying outcomes were found for each group of children. The paper's description of the four distinct groupings, their management and placement requirements, and outcomes should be of use to practitioners and managers planning placements for these children. The paper concludes that denial, minimization, normalization and helplessness all influence the management of sexually abused and/or abusing children and that these mirror the experiences of children who are sexually abused and their efforts to deal with the accompanying trauma.

Research paper thumbnail of Child Protection in a Multi-Racial Context

Policy & Politics, 1996

Between 1989 and 1993, the authors conducted research on decision making, intervention and outcom... more Between 1989 and 1993, the authors conducted research on decision making, intervention and outcome in child protection work (Farmer and Owen, 1995). The project was based at Bristol University and funded by the Department of Health. The main research, which was carried out in two local authorities, was extended to a metropolitan area in order to include a sample of Black children on the child protection register. This article outlines some of the findings from the sub-study, and highlights issues of importance when child protection work is carried out in a multi-racial context.

Research paper thumbnail of Family reunification with high risk children: Lessons from research

Children and Youth Services Review, 1996

Research paper thumbnail of How do placements in kinship care compare with those in non-kin foster care: placement patterns, progress and outcomes?

Child & Family Social Work, 2009

As the use of kinship care is set to rise in England, it is important that policy and practice de... more As the use of kinship care is set to rise in England, it is important that policy and practice developments are based on firm evidence about kin placement outcomes and how these compare with those in stranger foster care. The research reported in this paper was based on case file reviews of 270 children, half in kin placements and half in stranger foster care, and on interviews with a sub-sample of 32 kin carers, social workers, children and parents. Kin carers were found to be significantly more disadvantaged than stranger foster carers: more kin carers were lone carers, with health problems, living in overcrowded conditions and had financial difficulties. The children, in contrast, were remarkably similar in the two kinds of placement. The main differences between the children in the two settings are examined in the paper. The children's progress and outcomes in terms of placement quality and disruption were very similar in the two settings, but kin placements lasted longer, mainly because fewer were planned as interim placements. However, because kin carers persisted with very challenging children and yet received fewer services than stranger foster carers, they were more often under strain. The implications for policy and practice are examined.

Research paper thumbnail of Child protection practice: Private risks and public remedies

Child Abuse & Neglect, 1997

Research paper thumbnail of A Hidden Population: Understanding the Needs of Sexually Abused and Abusing Children in Substitute Care

Adoption & Fostering, 2005

Despite high levels of concern among professionals about how best to manage sexually abused child... more Despite high levels of concern among professionals about how best to manage sexually abused children looked after in public care, there has been little research on this subject. Sue Pollock and Elaine Farmer report the findings from a study of a sample of such children which shows that, as a group, they share characteristics that make them significantly more vulnerable to sexual risks and to emotional, educational and behavioural difficulties than their non-sexually abused counterparts in residential and foster care. However, at the point of placement there are rarely markers to alert carers to the multiple deprivations and adversities in their backgrounds and it is therefore likely that this group of children will be denied the specific targeted therapeutic, educational and family support that they need. This study highlights the importance of good record-keeping, thorough assessments of need at the point of placement, effective communication between social workers and caregivers a...

Research paper thumbnail of Restoring Children on Court Orders to their Families: Lessons for Practice

Adoption & Fostering, 1992

Research paper thumbnail of Family Finding and Matching in Adoption: What Helps to Make a Good Match?: Table 1

British Journal of Social Work, 2015

This study compared the effectiveness and outcomes of different family finding methods in adoptio... more This study compared the effectiveness and outcomes of different family finding methods in adoption in England, over-selecting harder to place children. The case files of 149 children with adoption recommendations in ten local authorities were reviewed and a sub-sample of sixty-seven cases were followed in real time, through interviews with professionals and families until six months after adoptive placement. Most matches were of good quality, but 14 per cent were fair and 13 per cent poor, involving serious compromises on matching requirements or adopters' preferences. There were more poor matches when in-house placements were made or children's difficulties were underplayed with new parents and, necessarily, more compromises were made when matching children with significant health or developmental needs. More good quality matches were made when case responsibility was transferred early to the adoption team. Poorer quality matches were related to poorer outcomes six months after adoptive placement. To improve matching, searches for families need to be widened early to avoid delays and to maximise the pool of adopters. Formal processes to track and review the progress of adoptions for children with complex needs (including matching meetings) can help avoid delay and ensure that a group of professionals, rather than an individual professional, makes key decisions.

Research paper thumbnail of Reunification: An Evidence-Informed Framework for Return Home Practice

Whilst we have made every effort to ensure the accuracy of this publication, we cannot guarantee ... more Whilst we have made every effort to ensure the accuracy of this publication, we cannot guarantee it and you should not rely on the contents of this publication. Registered charity England and Wales 216401. Scotland SC037717.

Research paper thumbnail of Growing Up in Kinship Care: Experiences as Adolescents and Outcomes in Young Adulthood

We have tried to represent accurately the many different experiences and views of kinship care in... more We have tried to represent accurately the many different experiences and views of kinship care in this report and also convey some of the complexity of the issues. However, if there are any errors they are solely our responsibility. Contents Contents 1. Introduction, aims and methods Methods 2. The young people and their kinship carers Age gender and ethnicity of the young people Disability Geographical location Age of the young people on entry into this kinship arrangement Stability and duration of the arrangement Relationship between the young people and their main kinship-carer Previous care arrangements Age of main kinship carer Legal status of the kinship arrangement Living arrangements at the point the young people were interviewed 3. Moving into kinship care Young people's understanding of why they had moved into kinship care Why the young people moved into kinship care-carers' accounts Prior relationships between the young people and their carers Support from Children's Services Contents 10. Moving out of the kinship home Young people still living in the kinship home Age of the young people on leaving kinship care Where young people moved to on leaving the kinship home Reasons for moving out of the kinship home Support provided by kinship carers as the young people moved out of the kinship home Support from the extended family and Children's Services when young people moved out of the kinship home The young person's relationship with the carer at the time of the interview Young people who did not maintain contact with carers Readiness to move out How the young people who had moved out were faring Involvement in crime Life course of the young people who had left home 11. Looking forward, looking back Young peoples' hopes and expectations for the future Anticipated life satisfaction in five years time Young people's three wishes Reflections: the young people's perspective Advice to other young people in kinship care Carer reflections Supporting children and young people in kinship care: the young people's views Supporting children and young people in kinship care: carers' views Supporting the kinship carers: carers' views 12. Summary and conclusions 1. Introduction, aims and methods Geographical location All the young people interviewed lived in England. Most lived in London (13, 25%), Yorkshire and the Humber (12, 23%) or the Northwest (10, 19%). One young person was from the South West. Others lived in the South East (7, 13%), North East (5, 9%), or East (5, 9%) of England.

Research paper thumbnail of Reunification from Out-of-Home Care:: A Research Overview of Good Practice in Returning Children Home from Care

This literature review was undertaken by the University of Bristol in order to inform a project c... more This literature review was undertaken by the University of Bristol in order to inform a project commissioned by the Department for Education in England. The views that are expressed in this work are those of the author and do not necessarily reflect those of the Department for Education. The objective of this joint University of Bristol and NSPCC project was to create, in partnership with local authorities, a research-informed Practice Framework for Reunification, to implement it and to evaluate how likely it was to improve reunification practice. This literature review was drawn on extensively in the development of the Practice Framework for Reunification, although it was finalised and published some time later. Grateful thanks are due to Mandy Wilkins coworker on the project for her expertise and to Julia Mayes and Samantha Kyriacou who have continued to work on dissemination and implementation of the project.

Research paper thumbnail of Improving Reunification Practice: Pathways Home, Progress and Outcomes for Children Returning from Care to Their Parents

British Journal of Social Work, 2012

Research paper thumbnail of Achieving Positive Outcomes when Reunifying Children – The Reunification Practice Framework

Research paper thumbnail of Fostering adolescents in England: what contributes to success?

Research paper thumbnail of Changing lives and changing minds: the experiences of adoptive parents from application to approval

Adoption & Fostering, 2014

The recruitment and preparation of adoptive parents is currently high on the government's agenda ... more The recruitment and preparation of adoptive parents is currently high on the government's agenda with a number of far-reaching changes in policy, processes and guidance having been introduced in recent months. The fundamental aim of adoption from care remains as being the provision of, hopefully, stable and loving families for children whose parents cannot care for them but the experiences of adoptive parents in this process has recently moved from the wings to centre stage. This paper introduces the reflections of a group of adoptive parents (n=27) about their experience of becoming adopters. The impact of delays in the process and experiences of the preparation and assessment period are discussed. A particular focus of the paper is on adopters' thoughts about the sorts of children they felt they could parent and how these changed in the course of their approval journey.

Research paper thumbnail of What Factors Relate to Good Placement Outcomes in Kinship Care?

British Journal of Social Work, 2009

Since recent legislation and other developments are likely to lead to increased use of placements... more Since recent legislation and other developments are likely to lead to increased use of placements with kin, this paper considers the evidence base about the factors that relate to good outcomes in kinship care in England. It is based on a study using case file reviews on 270 children, half of whom were in kin and half in stranger foster

Research paper thumbnail of Support for Adoption Placements: The First Six Months

British Journal of Social Work, 2013

The version in the Kent Academic Repository may differ from the final published version. Users ar... more The version in the Kent Academic Repository may differ from the final published version. Users are advised to check http://kar.kent.ac.uk for the status of the paper. Users should always cite the published version of record.

Research paper thumbnail of Foster Carer Strain and its Impact on Parenting and Placement Outcomes for Adolescents

British Journal of Social Work, 2005

Summary Drawing on recently completed research funded by the Department of Health, this article e... more Summary Drawing on recently completed research funded by the Department of Health, this article examines the extent of strain on the foster carers of adolescents, its influence on parenting practices and the overall impact on placement outcomes. The research find ings show that foster-carers' parenting capacity was markedly reduced in a number of specific areas when they had experienced a high number of stressful life events in the six months prior to the young person's arrival or were under considerable strain during the placement. Conduct problems, hyperactivity and violent behaviour by the young people increased carer strain, as did contact difficulties with the children's families. Problems in contacting social workers were linked to elevated strain, whilst strain was lessened when carers received help from friends or from local professionals. Signifi cantly higher disruption rates were experienced by strained carers and these placements were also less beneficial to the young people.

Research paper thumbnail of The Reunification of Looked After Children with Their Parents: What Contributes to Return Stability?

British Journal of Social Work, 2012

ABSTRACT Research information about reunification in the UK is scarce. Based on a prospective stu... more ABSTRACT Research information about reunification in the UK is scarce. Based on a prospective study of 180 children returned to their parent(s) in six local authorities in England, this article examines the factors that contributed to return stability during a two-year follow-up. Statistical analyses using logistic regression showed that a change in family membership since the child had entered care, foster carer assistance with returns, adequate preparation for and support during reunification, parental motivation to care and the involvement of another agency or professional in monitoring children were all related to return stability. Previous physical abuse to the child and previous failed returns were associated with reunification breakdown. The breakdown rates for the returns in our local authorities varied widely, especially for older children. Given the contribution of purposeful social work to return stability - as evidenced by appropriate preparation, services and monitoring of children's progress - local authorities need to develop clearer policies and practice advice on reunification for all children, whatever their legal status or age, backed up by appropriate resources. © The Author 2012. Published by Oxford University Press on behalf of The British Association of Social Workers. All rights reserved.

Research paper thumbnail of Implementing a Therapeutic Team Parenting Approach to Fostering: The Experiences of One Independent Foster-Care Agency

British Journal of Social Work, 2010

... Farmer E.,; Moyers S.,; Lipscombe J. Fostering Adolescents. London: Jessica Kingsley; 2004. .... more ... Farmer E.,; Moyers S.,; Lipscombe J. Fostering Adolescents. London: Jessica Kingsley; 2004. ... Adoption and Fostering 2006;30(3):6-16. ↵: Osborne C.,; Norgate R.,; Traill M. 'The role of the educational psychologist in multidisciplinary work relating to fostering and adoption'. ...

Research paper thumbnail of Patterns of Placement, Management and Outcome for Sexually Abused and/or Abusing Children in Substitute Care

British Journal of Social Work, 2004

This paper draws on the author's research on the management, care and treatment of sexually a... more This paper draws on the author's research on the management, care and treatment of sexually abused and/or abusing children in substitute care. The research, funded by the Department of Health, examined the management and treatment provided in residential and foster care for these young people, the mix of children in each setting and the steps taken to keep these and other children safe. Analysis of the findings revealed four distinct groups of young people in this population, each of which required somewhat different management approaches and placement type, whilst very varying outcomes were found for each group of children. The paper's description of the four distinct groupings, their management and placement requirements, and outcomes should be of use to practitioners and managers planning placements for these children. The paper concludes that denial, minimization, normalization and helplessness all influence the management of sexually abused and/or abusing children and that these mirror the experiences of children who are sexually abused and their efforts to deal with the accompanying trauma.

Research paper thumbnail of Child Protection in a Multi-Racial Context

Policy & Politics, 1996

Between 1989 and 1993, the authors conducted research on decision making, intervention and outcom... more Between 1989 and 1993, the authors conducted research on decision making, intervention and outcome in child protection work (Farmer and Owen, 1995). The project was based at Bristol University and funded by the Department of Health. The main research, which was carried out in two local authorities, was extended to a metropolitan area in order to include a sample of Black children on the child protection register. This article outlines some of the findings from the sub-study, and highlights issues of importance when child protection work is carried out in a multi-racial context.

Research paper thumbnail of Family reunification with high risk children: Lessons from research

Children and Youth Services Review, 1996

Research paper thumbnail of How do placements in kinship care compare with those in non-kin foster care: placement patterns, progress and outcomes?

Child & Family Social Work, 2009

As the use of kinship care is set to rise in England, it is important that policy and practice de... more As the use of kinship care is set to rise in England, it is important that policy and practice developments are based on firm evidence about kin placement outcomes and how these compare with those in stranger foster care. The research reported in this paper was based on case file reviews of 270 children, half in kin placements and half in stranger foster care, and on interviews with a sub-sample of 32 kin carers, social workers, children and parents. Kin carers were found to be significantly more disadvantaged than stranger foster carers: more kin carers were lone carers, with health problems, living in overcrowded conditions and had financial difficulties. The children, in contrast, were remarkably similar in the two kinds of placement. The main differences between the children in the two settings are examined in the paper. The children's progress and outcomes in terms of placement quality and disruption were very similar in the two settings, but kin placements lasted longer, mainly because fewer were planned as interim placements. However, because kin carers persisted with very challenging children and yet received fewer services than stranger foster carers, they were more often under strain. The implications for policy and practice are examined.

Research paper thumbnail of Child protection practice: Private risks and public remedies

Child Abuse & Neglect, 1997

Research paper thumbnail of A Hidden Population: Understanding the Needs of Sexually Abused and Abusing Children in Substitute Care

Adoption & Fostering, 2005

Despite high levels of concern among professionals about how best to manage sexually abused child... more Despite high levels of concern among professionals about how best to manage sexually abused children looked after in public care, there has been little research on this subject. Sue Pollock and Elaine Farmer report the findings from a study of a sample of such children which shows that, as a group, they share characteristics that make them significantly more vulnerable to sexual risks and to emotional, educational and behavioural difficulties than their non-sexually abused counterparts in residential and foster care. However, at the point of placement there are rarely markers to alert carers to the multiple deprivations and adversities in their backgrounds and it is therefore likely that this group of children will be denied the specific targeted therapeutic, educational and family support that they need. This study highlights the importance of good record-keeping, thorough assessments of need at the point of placement, effective communication between social workers and caregivers a...

Research paper thumbnail of Restoring Children on Court Orders to their Families: Lessons for Practice

Adoption & Fostering, 1992

Research paper thumbnail of Family Finding and Matching in Adoption: What Helps to Make a Good Match?: Table 1

British Journal of Social Work, 2015

This study compared the effectiveness and outcomes of different family finding methods in adoptio... more This study compared the effectiveness and outcomes of different family finding methods in adoption in England, over-selecting harder to place children. The case files of 149 children with adoption recommendations in ten local authorities were reviewed and a sub-sample of sixty-seven cases were followed in real time, through interviews with professionals and families until six months after adoptive placement. Most matches were of good quality, but 14 per cent were fair and 13 per cent poor, involving serious compromises on matching requirements or adopters' preferences. There were more poor matches when in-house placements were made or children's difficulties were underplayed with new parents and, necessarily, more compromises were made when matching children with significant health or developmental needs. More good quality matches were made when case responsibility was transferred early to the adoption team. Poorer quality matches were related to poorer outcomes six months after adoptive placement. To improve matching, searches for families need to be widened early to avoid delays and to maximise the pool of adopters. Formal processes to track and review the progress of adoptions for children with complex needs (including matching meetings) can help avoid delay and ensure that a group of professionals, rather than an individual professional, makes key decisions.

Research paper thumbnail of Reunification: An Evidence-Informed Framework for Return Home Practice

Whilst we have made every effort to ensure the accuracy of this publication, we cannot guarantee ... more Whilst we have made every effort to ensure the accuracy of this publication, we cannot guarantee it and you should not rely on the contents of this publication. Registered charity England and Wales 216401. Scotland SC037717.

Research paper thumbnail of Growing Up in Kinship Care: Experiences as Adolescents and Outcomes in Young Adulthood

We have tried to represent accurately the many different experiences and views of kinship care in... more We have tried to represent accurately the many different experiences and views of kinship care in this report and also convey some of the complexity of the issues. However, if there are any errors they are solely our responsibility. Contents Contents 1. Introduction, aims and methods Methods 2. The young people and their kinship carers Age gender and ethnicity of the young people Disability Geographical location Age of the young people on entry into this kinship arrangement Stability and duration of the arrangement Relationship between the young people and their main kinship-carer Previous care arrangements Age of main kinship carer Legal status of the kinship arrangement Living arrangements at the point the young people were interviewed 3. Moving into kinship care Young people's understanding of why they had moved into kinship care Why the young people moved into kinship care-carers' accounts Prior relationships between the young people and their carers Support from Children's Services Contents 10. Moving out of the kinship home Young people still living in the kinship home Age of the young people on leaving kinship care Where young people moved to on leaving the kinship home Reasons for moving out of the kinship home Support provided by kinship carers as the young people moved out of the kinship home Support from the extended family and Children's Services when young people moved out of the kinship home The young person's relationship with the carer at the time of the interview Young people who did not maintain contact with carers Readiness to move out How the young people who had moved out were faring Involvement in crime Life course of the young people who had left home 11. Looking forward, looking back Young peoples' hopes and expectations for the future Anticipated life satisfaction in five years time Young people's three wishes Reflections: the young people's perspective Advice to other young people in kinship care Carer reflections Supporting children and young people in kinship care: the young people's views Supporting children and young people in kinship care: carers' views Supporting the kinship carers: carers' views 12. Summary and conclusions 1. Introduction, aims and methods Geographical location All the young people interviewed lived in England. Most lived in London (13, 25%), Yorkshire and the Humber (12, 23%) or the Northwest (10, 19%). One young person was from the South West. Others lived in the South East (7, 13%), North East (5, 9%), or East (5, 9%) of England.

Research paper thumbnail of Reunification from Out-of-Home Care:: A Research Overview of Good Practice in Returning Children Home from Care

This literature review was undertaken by the University of Bristol in order to inform a project c... more This literature review was undertaken by the University of Bristol in order to inform a project commissioned by the Department for Education in England. The views that are expressed in this work are those of the author and do not necessarily reflect those of the Department for Education. The objective of this joint University of Bristol and NSPCC project was to create, in partnership with local authorities, a research-informed Practice Framework for Reunification, to implement it and to evaluate how likely it was to improve reunification practice. This literature review was drawn on extensively in the development of the Practice Framework for Reunification, although it was finalised and published some time later. Grateful thanks are due to Mandy Wilkins coworker on the project for her expertise and to Julia Mayes and Samantha Kyriacou who have continued to work on dissemination and implementation of the project.